The fact of "use of substances" is a little more complicated than these. For example, a person started smoking in 1995. He quit smoking after receiving smoking cessation therapy for two months in 2000. For some reason, he re-started smoking in 2001. How could we record the commence date and the re-commence date using the current archetype? How could we record the fact about quitting smoking, such as the times this person attempts to quit, with/without help, the therapies he received, etc.
Chunlan Gerard Freriks wrote: > The EHR is about recording observed facts. > > One of those facts is the "use of substances". > This means one has to document: > - What > - What for > - How > - How much > - When > - Prescribed by whom, when, where > - Dispensed by whom, when, where > - Administered by whom, when, where > - Used when > - ... > > Irrespective of a regular drug, herbal tea, food additive, smog, self > medicated, prescribed, or taken by an involuntary action > one always want to record the same things. > Isn't it? > > So why not a generic Archetypes: "Observation: Substance Use" > > Gerard > > > -- <private> -- > > Gerard Freriks, arts > > Huigsloterdijk 378 > > 2158 LR Buitenkaag > > The Netherlands > > > T: +31 252 544896 > > M: +31 653 108732 > > > > > On 10-mei-2006, at 15:53, Bill Walton wrote: > >> Hi Karsten, >> >> Karsten Hilbert wrote: >> >>> >>> Recording "substance use" is more intended to record a >>> *fact* about the lifestyle of an individual rather than an >>> *intent to treat* as with prescription drugs. >>> >>> There's a fine line as always: herbal teas, OTC drugs etc >>> may or may not have been intended to be treatment by the >>> provider. However, disambiguating such in a given case is at >>> the discreetion of the provider/patient in question. OpenEHR >>> needs to provide facilities for both. >> >> >> It seems to me that 1) we want to provide a mechanism for recording >> _all_ substances used, and 2) for each, we want to record who >> 'prescribed' it. Patients "intend to treat" when they ingest herbal >> teas, OTC drugs, etc.. While I definitely see the value in recording >> the 'prescriber', I still don't see the value in creating a seperate >> archetype for 'substances' that are not provider prescribed. In >> fact, it seems to me to create unnecessary complexity. >> >> Example... A patient is undergoing chemotherapy. The patient finds >> that smoking marijuana helps control the nausea. If the patient >> lives in California their physician can prescribe the use of >> marijuana. It they live in Texas, its use cannot be prescribed. >> >> Another example... A patient wants to quit smoking cigarettes. The >> physician prescribes Nicorette gum. Then the FDA approves Nicorette >> for OTC sale. >> >> What would be the information value of recording this information >> with different archetypes? What would seperate archetypes allow me >> to do that I couldn't do as easily with a single archetype with a >> 'prescriber' attribute that could accomodate a value of 'self'? >> >> Thanks, >> Bill > > -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20060511/d7ee900f/attachment.html>
